Palmar (Hands) Hyperhidrosis

Sweating of the hands may occur independently or in combination with sweating of the armpits, face and scalp, or feet. Facial blush may also be present. The most common combination is for the hands and the feet to be involved at the same time. The condition is caused by over-stimulation of the sweat glands by the sympathetic nervous system. Hand sweating can be severe. Many patients sweat so profusely that the sweat actually drips onto the floor. These symptoms may occur in even the coldest of conditions. Other patients may not drip sweat, but their hands are usually discoloured, cold and clammy. Newspaper print stains their hands and books will have curled edges from the constant moisture on their hands. Prior to the onset of sweating, many patients report a tingling in their fingers or report that "my skin pores are opening up". The mechanism is involuntary and cannot be consciously controlled. There is a usually an interrelationship between anxiety and sweating that develops to a greater or lesser degree in nearly all patients with severe hyperhidrosis. The condition is often aggravated by anxiety and the onset of symptoms is in itself anxiety provoking, thus a vicious cycle is created. Many individuals try to escape by withdrawing or avoiding stressful situations. This repetitive pattern only serves to create more emotional injury.

During conversations with others, those with hyperhidrosis may hide their hands under their arms, behind their backs or placed under their thighs. Many patients have reported that, during a party or some social gathering, holding a cold drink in their hands makes shaking hands with others socially acceptable. People would assume that the hand they just shook was cold and clammy because of the cold drink and not because the afflicted was nervous. One young professional woman mentioned that, before a job interview, she would park her car and rub her hands on the tire. She would then tell the interviewer that she had had a flat tire and she shouldn't shake his hand because her hands were dirty.

Treatments For Palmar Hyperhidrosis

Fortunately with the recent advances in medicine, many forms of treatment are available to treat palmar hyperhidrosis. An effective antiperspirant is the treatment of first choice, iontophoresis (home kits are now available but the hospital equipment is still stronger to start with), botox (works, but is expensive and lasts only six to twelve months), low dose medication and surgery are also used to treat hyperhidrosis. Endoscopic thoracic sympathectomy or ETS can be an effective method to treat hyperhidrosis, however, great care must be taken in choosing a surgeon and the risk of side effects from compensatory sweating should be considered carefully.

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